The invention is directed to surgical instruments, specifically, surgical pins used to indicate the location of the various parts of the human shoulder anatomy while arthroscopic acromioplasty is being performed.
Arthroscopic acromioplasty is performed to relieve the symptoms of chronic bursitis of the shoulder. Generally, chronic bursitis may occur as a result of the acromion process of the scapula impinging upon the underlying rotator muscles and associated ligaments. This impingement may be the result of an injury to the shoulder or the result of bone spurs formed on the acromion which impinge upon the rotator muscles and associated ligaments, or bone spurs formed in the acromioclavicular joint, either on the clavicle or the acromion, which would direct the acromion to impinge against the rotator muscles and associated ligaments.
There are various approaches to treat shoulder bursitis depending upon the severity of the inflammation. These treatments include specific types of exercise developed to relieve the inflammation and also include the use of medication. However, certain cases of shoulder bursitis can not be relieved by the use of these nondestructive techniques and the only recourse would be surgery.
Generally, the surgical technique performed on the shoulder to alleviate the suffering caused by the bursitis involves the resection of the underlying area of the acromion, that is, the underlying anterior and posterior portion of the acromion, which impinges upon the rotator muscles and associated ligaments. It may also be necessary to surgically remove any bone spurs found on the acromion or clavicle, or to excise a portion of the coracoacromial ligmant.
While this surgery may be performed as an open surgical procedure, the more typical approach is to perform arthoscopic surgery, more specifically, arthroscopic acromioplasty. Arthroscopic surgery reduces the damage which typically occurs with open surgical procedures, e.g., morbidity, and promotes earlier rehabilitation.
The major drawback with arthroscopic surgery, and in particular arthoscopic acromioplasty, is the difficulty in visually observing and distinguishing between the various bones and ligaments of the shoulder anatomy. It is further difficult to precisely ascertain the location of the acromion at which the resection is to be performed and to determine with any degree of accuracy the extent of the resection.
Typically, the surgeon will mark the patient's skin about the shoulder to provide the general location of the underlying acromion, clavicle, acromioclavicular joint and other structures of the shoulder. The surgeon will then refer to these markings during the operation and estimate which part of the shoulder anatomy he is observing through the arthroscope and the location of the acromion to be resected.
While a skilled surgeon may adequately perform the arthroscopic acromioplasty using these exterior markings as reference points, there exists the possibility that the wrong area of the acromion will be resected, or more probably that the estimated extent of the resection will be either too low, or more dangerous, too high. The extent of the resection is usually visually estimated by comparing the depth of the resection to the surrounding facie. However, even under the most favorable conditions the surgeon must still estimate both the location of the acromion to be resected and the extent of the resection.
It is thus apparent that any improvement in the ability to visually observe both the precise identity of the various parts of the shoulder anatomy, the location of that area of the acromion to be resected and the extent of the resection, would be an improvement over the current procedure.